The present invention relates generally to intestinal catheters, and more particularly to an intestinal catheter, inserted by use of an endoscope or a guidewire in combination with a bolus, for the purpose of aspirating the contents of the stomach and delivering feeding solutions to the small intestine.
The gastrointestinal tract comprises, in descending order from the mouth or nose, the esophagus, the stomach, the small intestine and the large intestine. The small intestine or bowel comprises, in descending order, the duodenum, connected to the stomach through an opening called the pylorus, the jejunum, which connects with the duodenum at a location identified by an adjacent ligament called the Ligament of Treitz, and the ileum, which in turn connects with the large bowel.
It is often desirable to emplace within the gastrointestinal tract a catheter where the downstream end of the catheter is located in the small intestine. Nelson, U.S. Pat. No. 4,676,778 and Nelson, U.S. Pat. No. 4,368,739 describe devices which can be emplaced within the small intestine. Those devices are designed to be inserted during surgery and are provided with pairs of inflatable balloons which facilitate the manipulation of the catheter through the small intestine. Because those devices require manual manipulation of the intestinal tract, they are inserted only during surgery.
There are techniques for insertion of intestinal catheters which do not involve surgery. Single lumen feeding tubes have been inserted into the intestine by use of an endoscope which attaches to a thread or cord at the downstream end of the catheter. Such catheters have sometimes been equipped with a weight or bolus portion in the catheter and are described in Russo, U.S. Pat. No. 4,769,014.
Another technique for insertion of a catheter into the intestine is by use of a guidewire. The guidewire is inserted into the tube for the purpose of adding rigidity and directional memory to the tube, and the tube and guidewire are inserted into the gastrointestinal tract. The catheter and guidewire move through the gastrointestinal tract by manipulating the guidewire at the upstream or operator end of the tube. A radiologist uses a fluoroscope to determine the position of the guidewire and catheter and to aid in moving them further through the gastrointestinal tract.
In the past, use of an endoscope or guidewire to emplace a catheter deep into the small intestine is not always satisfactory. The tight curves in the small intestine make maneuvering a catheter difficult either with an endoscope or with a guidewire. Moreover there is a need for a simple method of replacing a catheter which has been previously emplaced by use of an endoscope or a guidewire.